Provider Demographics
NPI:1134105828
Name:ERICKSON, DEBORAH J (PT CHT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:PT CHT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4220 132ND ST SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8999
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:201 W NORTH RIVER DR
Practice Address - Street 2:SUITE 510
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2284
Practice Address - Country:US
Practice Address - Phone:503-323-0066
Practice Address - Fax:509-323-0067
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO8707225100000X
WAPT 00003896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8933026Medicare PIN